A client is brought to the emergency department by ambulance with chest pain 10/10 which began 30 minutes prior. The client's troponin levels are 1.20 ng/mL and an ST-elevation is noted on the electrocardiogram (ECG). The nurse understands that the priority intervention for this patient is which of the following?
Transport the patient to the cardiac catheterization lab for percutaneous coronary intervention (PCI).
Begin aggressive diuresis with furosemide and obtain an order for digoxin.
Prepare the patient for synchronized cardioversion and radiofrequency catheter ablation.
Administer gemfibrozil (Lopid) while preparing the client for a cardiac stress test.
The Correct Answer is A
A. Transporting the patient to the cardiac catheterization lab for percutaneous coronary intervention (PCI) is the priority intervention for a patient with an ST-elevation myocardial infarction (STEMI). PCI is the preferred treatment to restore blood flow to the affected coronary artery.
B. Aggressive diuresis and digoxin are not appropriate for the acute management of a STEMI. Diuresis may be used in cases of heart failure but is not the immediate priority.
C. Synchronized cardioversion and radiofrequency catheter ablation are treatments for certain arrhythmias but are not indicated for the acute management of STEMI.
D. Administering gemfibrozil, a lipid-lowering agent, and preparing for a stress test are not appropriate interventions in the acute setting of a STEMI. Immediate reperfusion therapy is necessary.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
A. Intrascapular pain and indigestion can be atypical presentations of myocardial infarction, particularly in women.
B. Pain and swelling in one lower limb suggest deep vein thrombosis (DVT), not myocardial infarction.
C. Elevated serum creatinine indicates kidney dysfunction but is not a direct manifestation of myocardial infarction.
D. Crackles in the lungs and elevated temperature suggest possible infection or heart failure exacerbation, but not specifically myocardial infarction.
Correct Answer is D
Explanation
A. Alopecia is a common side effect of chemotherapy but does not necessitate immediate hospital visit.
B. Loperamide is used to treat diarrhea, not nausea. Antiemetics are used for chemotherapy-induced nausea.
C. Desquamation is not a typical side effect of daunorubicin; skin assessment is not the primary concern.
D. Daunorubicin can cause cardiotoxicity; therefore, reviewing the client's most recent echocardiogram is essential to assess cardiac function before administration.
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